SynthesisFrontiers in oncology2025
Synergistic efficacy and safety of PD-1/PD-L1 inhibitors combined with nab-paclitaxel and platinum chemotherapy in NSCLC: A systematic review and meta-analysis of randomized controlled trials.
Synthesis in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Non-small cell lung cancer (NSCLC), the leading cause of cancer mortality, often requires platinum-based chemotherapy. Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) improves drug delivery, while PD-1/PD-L1 inhibitors enhance antitumor immunity. Preclinical studies suggest synergy, but clinical evidence for combining these agents remains limited. Methods: Following PRISMA guidelines, this meta-analysis pooled data from four randomized controlled trials (1998 patients). Databases (PubMed, Embase, Cochrane Central, web of science) were searched until January 2025. Trials comparing PD-1/PD-L1 inhibitors + nab-paclitaxel-platinum (experimental) versus chemotherapy alone (control) were included. Outcomes included including objective response rate (ORR), progression-free survival (PFS), overall survival (OS), pathologic complete response (pCR), major pathologic response (MPR), and grade ≥3 adverse events (AEs). Statistical analyses used fixed/random-effects models. Results: The combination therapy significantly improved ORR (OR = 1.81, 95% CI: 1.49-2.20, Conclusion: PD-1/PD-L1 inhibitors combined with nab-paclitaxel-platinum enhance survival outcomes in NSCLC, particularly for PD-L1-high patients. Despite increased immune-related toxicity risks, this regimen represents a promising first-line option, warranting biomarker-driven selection and vigilant AE management. Future studies should address heterogeneity in platinum agents and optimize patient stratification.
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